Construction and Validation of a Clinical Prediction Model for External Cephalic Version
CHENG Chunhua
LI Genxia
FENG Shuo
LI Jiao
Abstract：Objective To discuss the factors affecting the success of external cephalic version(ECV),and to establish a clinical prediction model to guide perioperative clinical decision-making.Methods The ECV cases in the Third Affiliated Hospital of Zhengzhou University from July 2015 to October 2022 were retrospectively reviewed.Logistic regression was used to investigate the influencing factors of ECV success,and R language was used to build a nomogram model.The Hosmer-Lemeshow test was used to judge the calibration ability of the model,the area under the receiver operating characteristic(ROC)curve was used to evaluate the clinical efficacy of the model,and the model was presented as a formula and a nomogram.Results A total of 107 cases were included for modelling,of which 65 cases were successful(60.7％),and 95 cases were included for validation,of which 57 cases were successful(60.0％).The skill level of the operator reached"technical stability"when performing ECV surgery in 5 postpartum women and 15 primiparous women.The independent variables of the model were placental position,maternal type,operator proficiency and amniotic fluid index(AFI).The model cohort AUC was 0.779(95％CI:0.685-0.872),Hosmer-Lemeshow test P=0.350,Brier score 0.179.The AUC of the validation cohort was 0.719(95％CI:0.612-0.825).The Delong test showed no statistical significance between the ROC curves of the model cohort and the validation cohort(P=0.409).Conclusion ECV is a successful,safe technique with a high rate of subsequent vaginal delivery.The model has good calibration and predictive ability.Nomogram has a good ability to predict the success rate of ECV.
Keywords：external cephalic versionbreech presentationclinical prediction model
Publication Date：2025-06-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 1968-1973 )